caa a22 4500 463179749 CHVBK 20180406164835.0 cr unu---uuuuu 170326e20071201xx s 000 0 eng 10.1007/s00381-007-0467-6 doi (NATIONALLICENCE)springer-10.1007/s00381-007-0467-6 Early treatment of anterior calvarial craniosynostosis using endoscopic-assisted minimally invasive techniques [Elektronische Daten] [David Jimenez, Constance Barone] Background: A total of 100 patients who presented with synostosis of the metopic or coronal suture were consecutively treated during a 6-year period using minimally invasive endoscopic-assisted suturectomies. After surgery, all patients were fitted with custom-made cranial helmets for up to 12months. Materials and methods: The coronal group consisted of 50 patients, 26 females and 23 males with a mean age of 3.78months. Surgery was done through a single 2-mm incision at the ipsilateral stephanion. After endoscopic-assisted dissection, a craniectomy of the involved suture was done (mean width, 6mm, and mean length, 10cm). The metopic group consisted of 50 patients, 35 males and 16 females with a mean age of 4.1months. A single 2- to 3-cm incision was placed on the midline behind the hairline. A suturectomy of the suture from anterior fontanelle to nasofrontal suture was performed (mean width, 7mm, and mean length, 9.8cm). Results: For the entire cohort, the mean estimated blood loss was 34cc (5-250cc). The mean estimated percent of blood volume lost was 5.2% (1-26%). There were no intraoperative blood transfusions and five postoperative for a total transfusion rate of 6.7%. The mean surgical time was 56min. All but one patient (99%) was discharged on the first postoperative day. Complications included two dural tears and four pseudomeningoceles. There were two cases of incomplete reossification of the craniectomy. There were no infections, mortalities, hematomas, or visual injuries. There were no complications related to helmet therapy except three superficial skin breakdowns that cleared immediately with helmet non-use for 3-4days. Using anthropometric measurements and extensive photographic and physical assessments, excellent results were obtained in 84%, good results in 9%, and poor results in 7% of patients. Conclusions: Early treatment of infants with coronal or metopic craniosynostosis using endoscopic assisted minimally invasive suturectomies is a safe and efficacious treatment alternative associated with excellent results in a large portion of these patients. Springer-Verlag, 2007 Craniosynostosis nationallicence Endoscopic-assisted minimally invasive techniques nationallicence Suture nationallicence Jimenez David Department of Neurosurgery, The University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, MC 7843, 78229, San Antonio, TX, USA aut Barone Constance Division of Plastics and Reconstructive Surgery, Department of Surgery, The University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, MC 7844, 78229, San Antonio, TX, USA aut Child's Nervous System Springer-Verlag 23/12(2007-12-01), 1411-1419 0256-7040 23:12<1411 2007 23 381 https://doi.org/10.1007/s00381-007-0467-6 text/html Onlinezugriff via DOI 1 research-article jats NATIONALLICENCE 856 40 https://doi.org/10.1007/s00381-007-0467-6 text/html Onlinezugriff via DOI NATIONALLICENCE 700 1- Jimenez David Department of Neurosurgery, The University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, MC 7843, 78229, San Antonio, TX, USA aut NATIONALLICENCE 700 1- Barone Constance Division of Plastics and Reconstructive Surgery, Department of Surgery, The University of Texas Health Science Center at San Antonio, 7703 Floyd Curl Drive, MC 7844, 78229, San Antonio, TX, USA aut NATIONALLICENCE 773 0- Child's Nervous System Springer-Verlag 23/12(2007-12-01), 1411-1419 0256-7040 23:12<1411 2007 23 381 Metadata rights reserved Springer special CC-BY-NC licence nationallicence BK010053 XK010053 XK010000 NATIONALLICENCE NATIONALLICENCE NL-springer